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. 2018 Jan 23;8(1):e016297.
doi: 10.1136/bmjopen-2017-016297.

Is the association between health-related quality of life and fatigue mediated by depression in patients with multiple sclerosis? A Spanish cross-sectional study

Juan J Fernández-Muñoz  1 , Margarita Cigarán-Méndez  1 , Esperanza Navarro-Pardo  2 , Marta Pérez-de-Heredia-Torres  3 , Paula Parás-Bravo  4 , César Fernández-de-Las-Peñas  3
Affiliations

Is the association between health-related quality of life and fatigue mediated by depression in patients with multiple sclerosis? A Spanish cross-sectional study

Juan J Fernández-Muñoz et al. BMJ Open. .

Abstract

Objectives: To determine the mediating effects of depression on health-related quality of life and fatigue in individuals with multiple sclerosis (MS).

Design: A cross-sectional study.

Setting: Tertiary urban hospital.

Participants: One hundred and eight patients (54% women) with MS participated in this study.

Outcome measures: Demographic and clinical data (weight, height, medication and neurological impairment), fatigue (Fatigue Impact Scale), depression (Beck Depression Inventory-II) and health-related quality of life (Short-Form Health Survey 36) were collected.

Results: Fatigue was significantly associated with bodily pain, physical function, mental health and depression. Depression was associated with bodily pain and mental health. The path analysis found direct effects from physical function, bodily pain and depression to fatigue (all, P<0.01). The path model analysis revealed that depression exerted a mediator effect from bodily pain to fatigue (B=-0.04, P<0.01), and from mental health to fatigue (B=-0.16, P<0.01). The amount of fatigue explained by all predictors in the path model was 37%.

Conclusions: This study found that depression mediates the relationship between some health-related quality of life domains and fatigue in people with MS. Future longitudinal studies focusing on proper management of depressive symptoms in individuals with MS will help determine the clinical implications of these findings.

Keywords: depression; fatigue; multiple sclerosis; quality of life.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Path analyses relating mental health, bodily pain and physical function with fatigue with the intermediate effect of depression. Standardised direct path coefficients are presented. In this model mental health predicts depression, while the independent variable (fatigue) is predicted by depression and also directly by physical activity. The straight arrows represent regression paths for presumed causal relationships, while the curved double-headed arrows represent assumed correlations among the variables.
See this image and copyright information in PMC

References

    1. Melcon MO, Correale J, Melcon CM. Is it time for a new global classification of multiple sclerosis? J Neurol Sci 2014;344:171–81. 10.1016/j.jns.2014.06.051 - DOI - PubMed
    1. Fernández O, Fernández V, Guerrero M, et al. . Multiple sclerosis prevalence in Malaga, Southern Spain estimated by the capture-recapture method. Mult Scler 2012;18:372–6. 10.1177/1352458511421917 - DOI - PubMed
    1. Otero-Romero S, Roura P, Solà J, et al. . Increase in the prevalence of multiple sclerosis over a 17-year period in Osona, Catalonia, Spain. Mult Scler 2013;19:245–8. 10.1177/1352458512444751 - DOI - PubMed
    1. Candeliere-Merlicco A, Valero-Delgado F, Martínez-Vidal S, et al. . Prevalence of multiple sclerosis in health district III, Murcia, Spain. Mult Scler Relat Disord 2016;9:31–5. 10.1016/j.msard.2016.06.003 - DOI - PubMed
    1. Shah A. Fatigue in multiple sclerosis. Phys Med Rehabil Clin N Am 2009;20:363–72. 10.1016/j.pmr.2008.12.003 - DOI - PubMed